Older people receive worse NHS cancer care

Older people with cancer are more likely to die in England than in other leading countries because of “age bias” in the NHS according to new research.The study from the King’s Fund found that pensioners tended to be diagnosed with the disease later and were less likely to receive surgery.

Some 15,000 people over 75 in Britain die prematurely from cancer each year compared with better performing countries, according to estimates.

The report said there was “substantial evidence” that older patients were under treated on the NHS and that their chances of survival were “poorer as a result”.

It found the elderly were less likely to receive proper tests or surgery and more likely to be seen when their cancers were advanced and so beyond treatment.

The study identified “age bias” in the NHS as a factor behind this.

Catherine Foot, Senior Fellow at the King’s Fund, said: “England still has a way to go to reach cancer survival rates that are ranked with the best international performers. The evidence points to early diagnosis as being key to improving outcomes.

“We hope urgent priority is given to closing the gap in survival rates between different groups in society. We found that older people are particularly burdened by this, being more likely to have cancer, to be diagnosed later, to be under-treated and to experience worse outcomes.”

Ministers have repeatedly cited England’s relatively poor performance in cancer survival as justification for their unprecedented reform of the NHS, repeatedly claiming that 5,000 lives could be saved a year if standards were raised although some health experts have queried this figure.

The new report by the King’s Fund think-tank acknowledges that overall cancer survival rates are improving, but agrees with the Government that England’s performance is still worse than that of several other developed countries.

One important factor behind the generally lower survival rates in England is late diagnosis, the study found.

For example, the difference between England and the Nordic countries for all cancers is 10.8 per cent.

But, if patients who have been diagnosed late and have died after a year are excluded, this falls to 3.6 per cent. This suggests that late diagnosis causes a large chunk of the difference.

Chances of surviving colorectal, breast, lung and ovarian cancer are “persistently lower” in parts of Britain and Denmark than areas of Australia, Canada, Sweden and Norway, with the gap having “widened slightly” for lung cancer, according to the report.

It said there was “strong evidence” that delays in diagnosis by GP and in accessing care partly explained the difference.

In addition, some studies have suggested that patients in some parts of Britain are far less likely to likely to have surgery on tumours than others, while more people should receive radiotherapy.

Ciaran Devane, Chief Executive at Macmillan Cancer Support, said: “There is strong evidence to show that age, not their health, is the main consideration when choosing the most appropriate cancer treatment for older people. It is absolutely vital that we look at new assessment methods in order to improve survival rates and the experience of older people with cancer.”